Infectious Disease

COVID-19 is more severe than influenza in people with autoimmune diseases

March 30, 2021

3 min read

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Tan does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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COVID-19 is more severe, with more complications and higher mortality than influenza in patients with autoimmune diseases, according to data in Rheumatology.

“With autoimmune disease being a recognized risk factor for COVID-19-related complications, health authorities around the world have recommended risk reduction strategies for those at risk.” Scary Hay Tan, PhD, MPH, BSc, from the University of Oxford in the UK and colleagues wrote. “In the absence of a vaccine and a lack of proven therapeutic options, non-pharmacological measures such as shielding, case isolation, strict hand hygiene and social distancing are key measures to protect this vulnerable population.”

COVID-19 is more severe, with more complications, and higher mortality than influenza in patients with autoimmune diseases, according to data.

“So far, characterization studies of COVID-19 infection in people with autoimmune diseases have been limited in sample size and mostly region-specific,” they added. “As a result, the COVID-19 results in people with autoimmune diseases are still little known. Given the ongoing threat from COVID-19, clinical understanding of the characteristics and prognoses of patients with autoimmune diseases will facilitate treatment management for this patient population. “

To analyze 30-day outcomes and post-hospital mortality for COVID-19 in patients with autoimmune diseases versus those for seasonal influenza in similar patients, Tan and colleagues conducted a network cohort study using electronic health records from a multinational collection of facilities by.

Electronic sources included Columbia University’s Irving Medical Center in New York; Optum based in the USA; the US Department of Veterans Affairs; and the information system for research on primary care and hospital stays in Spain. Damage data was obtained from Health Insurance and Review Assessment in South Korea and IQVIA Open Claims in the USA.

The researchers included all patients with common autoimmune diseases who were diagnosed with COVID-19 or hospitalized between January and June 2020. This included 133,589 patients diagnosed with COVID-19 and 48,418 patients hospitalized with COVID-19. The researchers compared these cases to 70,660 similar patients hospitalized with influenza from 2017 to 2018. The main outcomes were death and complications within 30 days of hospitalization.

According to the researchers, psoriasis was the most common autoimmune disease among those who developed COVID-19, ranging from 3.5% to 27.9%; rheumatoid arthritis 4% to 18.9%; and vasculitis ranging from 3.3% to 17.5%).

In autoimmune disease patients admitted to hospital with COVID-19, the prevalence was hypertension (absolute standardized mean difference = 0.18-0.34), chronic kidney disease (ASMD = 0.17-0.25), heart disease (ASMD = 0.18 to 0.28), type 2 diabetes (ASMD = 0.15 to 0.32), chronic obstructive pulmonary disease (ASMD = 0.11 to 0.20) and the use of antithrombotic drugs (ASMD = 0 , 15 to 0.28) were all higher than those diagnosed with COVID but not hospitalized. 19th

Compared to patients with influenza, patients with COVID-19 had more respiratory complications, including pneumonia (12.6% to 53.2%, compared with 19.5% to 36.3%) and acute respiratory distress syndrome (14.7%) up to 42.8%). compared to 16.9% to 28.7% – and a higher 30-day mortality – at 6.3% to 24.6%, compared with 2.2% to 4.4%.

“Because autoimmune diseases are a risk factor for COVID-19 complications, our study was important to provide a clinical understanding of the characteristics and prognoses of patients with autoimmune diseases,” Tan told Healio Rheumatology. “Most autoimmune disease patients who were hospitalized for COVID-19 were women, older, and had previous comorbidities. In particular, there was a higher prevalence of high blood pressure, chronic kidney disease, and heart disease in these patients. Compared to influenza, patients admitted with COVID-19 had more complications and higher 30-day mortality. “

“COVID-19 is a more serious illness compared to influenza,” she added. “We found certain comorbidities that were more common in autoimmune disease patients hospitalized with COVID-19 than in patients diagnosed with COVID-19. Future studies should investigate predictors of poor outcomes associated with COVID-19 infection in this vulnerable group of patients. “

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